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Health IT Systems Tested by Superstorm Sandy

Everyone knew Superstorm Sandy - a storm many meteorologists called the worst storm to ever hit the Northeast U.S. - was coming and would pack a wallop. It was widely reported in the days prior to Sandy's landfall that there would be widespread power outages, and the predictions were mostly correct; the Department of Energy Situation reported power failures for approximately 8.5 million customers in total across 13 states as a result of the storm.

Some of those failures affected healthcare facilities, including doctor's offices, health centers and hospitals. With a great many facilities moving to electronic health records (EHRs) in recent years - more than 2,000 hospitals and 41,000 doctors in the U.S. now use EHRs - power failures can mean possible chaos and confusion when trying to provide proper care to patients. So as Sandy gathered speed off the Atlantic coast, so did efforts to protect patients' records and the ability to provide care in the event of a power failure.

There's the perception that patient medical data living on a hard drive can easily be lost, especially during a catastrophic weather event or power outage. While this may be true if the proper safeguards aren't enacted, the fact is that the risk of losing patient data can be increased with traditional paper medical records.

"Hurricane Katrina helped to start moving people toward EHRs," said Bill O'Byrne, executive director of NJ-HITEC, a national leader in providing EHR guidance to healthcare practitioners. "Peoples' entire medical histories were wiped out during that storm, and there was no way to ever get those back. One of our jobs before this storm was to help our 6,200 docs keep their information safe because information doesn't mix well with water."

NJ-HITEC sent out a "disaster recovery precaution" checklist to all of its members detailing options for how to back up and protect medical information in the lead-up to the storm. The handout made suggestions such as backing up medical records on external drives and removing the drives from the office so records exist in more than one location.

South Jersey Healthcare (SJH) Elmer Hospital in Elmer, N.J,, employs an inpatient EHR system. The facility also experienced a power outage during Sandy. "Our backup generator kept the EHR functional, though," said Nancy Cimprich, information systems director of customer services for SJH. She also said SJH created a "customized response" in anticipation of Sandy, given the nature of the storm and its potential for presenting certain challenges that were "beyond the norm," in her words.

"We had 10 tech experts stay the night at our various facilities in case we needed people to quickly restore operations," she said. "We also have downtime computers on every floor of our hospitals. Critical patient data, such as medication administration information, is sent to these downtime computers with regular frequency - some information is updated every 30 minutes - and the downtime computers have the capability to print medical records in the event of a total power failure," Cimprich added.

At NYU Langone Medical Center in lower Manhattan, patients had to be evacuated mid-storm after flooding knocked out the hospital's backup generators. But those patients' charts didn't have to be evacuated with them because the State of New York employs a health information exchange called SHIN-NY that connects 78 percent of all hospitals statewide. The ability for patient records to be readily available at other facilities means healthcare providers can promptly and confidently provide quality care to patients. This is not possible with paper records.

At Montefiore Medical Center, Bronx, NY, precautions were also taken.

"As part of our emergency preparedness response, Montefiore's IT department ensured that, in the unlikely event our systems failed, we could rapidly convert EHRs to a paper record," said Susan Green-Lorenzen, senior vice president of operations. "Montefiore's system is designed to print critical medical records, such as documentation and medication administration records, in the event that our EHR goes offline."

Virginia Beach, Va., received about nine inches of rain during Sandy. Dale Gauding, spokesperson for Sentara Healthcare, said none of the Sentara hospitals in the Virginia Beach area had to use emergency power. "But we have a manual backup system in place in the event that our EHR system goes down," Gauding said. "We drill the manual system once or twice per year with our staff, so patients won't suffer from any interruptions in care if our systems did go down."

It's becoming clear EHRs are the future - and the federal government has mandated their use nationwide by 2014. EHRs also continue to get more high-tech and interconnected, with the SHIN-NY system being a great example of how patient care can be coordinated and delivered, even in the event of a system failure. According to O'Byrne, a national EHR system may soon be a reality. Should that come to pass, patients benefit, and superstorms like Sandy may no longer present such a threat.

Chris Kinsey is a regular contributor to ADVANCE.

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